What Is Medical Billing and Coding: An Introduction

Thus there is often the opportunity to combine these two fields – and somebody who has mastered the skills of both can often either get higher paying positions or increase their general job prospects since there will be more job opportunities for them to choose from.

What Is Medical Billing?

Medical billing is the end of medical/hospital administration that deals with billing insurance companies, lawyers, and patients themselves for medical services that have been rendered.

Most patients are insured either by a private company or by federal insurance programs like Medicaid and Medicare. These companies need a succinct statement of the services and procedures of a health provider, specifics of their insured patient’s medical record, information concerning the spontaneous or pre-existing nature of a medical condition and so on.

This is all the responsibility of a medical biller.

In addition, a medical biller can also work from “the other end”; at the insurance companies themselves. Here the biller makes sure that an insured has paid his or her portion of the cost for medical service (i.e. the deductible), and that the entire medical bill is thus taken care of. Often there are disputes as to what an insured should pay versus what the insurance company is responsible for, and the medical biller works to sort out these problems and collect payments.

What Is Medical Coding?

Medical coding is a more specific focus that deals with same basic branch of medical administrative/office work. In order for information to be transferred easily among the parties involved in a medical transaction – usually health care provider, patient, and insurance company, – there are various alpha numerical codes used that designate diagnoses, medical procedures, medications (pharmaceutical codes), and even various areas on the body (known as topographical codes).

The medical coder is an expert in these codes and makes sure that medical documentation is accurate. Often the coder takes the basic data in a patient’s file – the doctor’s diagnosis of a patient’s condition, what treatment was given both in terms of medical procedures, medications, and doctor recommendations, and so on, and converts all this data into the appropriate codes.

Thereafter, the different code groups must be associated together on a single medical document or bill so that accurate cost information can be arrived at. The codes are recognized all across the medical industry, allowing for quick processing of insurance claims, assessment of required payments, and general clarity concerning a patient’s status.

How Are Medical Billing and Medical Coding Related?

So it should be fairly obvious how these two fields are connected. A medical biller needs either to work with a medical coder or know medical coding himself or herself in order to accurately document medical information.

The two skill sets being closely related and interdependent as they are, educational programs often combine medical billing and coding into a single curriculum. So if you’re considering getting into this type of field, consider looking for education programs that offer instruction in both. Simply use the form on this site to search popular educational databases for “medical billing and coding training” or something similar.

Of the two fields, medical coding is considered slightly more highly skilled. But if you can get a good handle on both, you’ll be that much more employable. There is nothing wrong with specializing in one or the other, and they are roughly comparable in pay.

But if you do specialize in one of these, make sure you know it well. There is a lot of job possibility in this field so there are many possibilities. But it’s your responsibility to be as well trained as possible in whatever field of combination of fields you choose.